Artificial respiration involves assisting or stimulating a person's natural respiration, a metabolic process referring to an exchange of gases within the body by pulmonary ventilation, external respiration and internal respiration. Pulmonary ventilation is achieved through manual insufflation of a person's lungs by causing air or oxygen to flow in and out of a person's lungs, generally when natural breathing has stopped or is otherwise inadequate.
One method of pulmonary ventilation involves intubation, or entubation, which pertains to the insertion of a tube generally into an external orifice of the body. Once particular method of intubation is tracheal intubation, in which a flexible plastic tube is inserted into the trachea (windpipe) of a person to provide or maintain an open airway, or to serve as a conduit through which to administer certain drugs. Tracheal intubation is often performed in critically injured or anesthetized patients to facilitate pulmonary ventilation and to prevent the possibility of asphyxiation or airway obstruction. Tracheal intubation is most often orotracheal, or endotracheal, in which an endotracheal tube is passed through the mouth and vocal apparatus of a person and into the trachea.
During an endotracheal intubation, the person's mouth is opened and the endotracheal tube is inserted down the throat. To better ensure the endotracheal tube is properly positioned, a laryngoscope may be used to bring the vocal cords and larynx into view prior to inserting the endotracheal tube. The tube may then inserted in the trachea through the vocal cords to the point that an inflation cuff surrounding a distal end portion of the tube rests just below the vocal cords. Finally, after an inflation cuff is inflated to inhibit leakage, a bag valve mask is squeezed at a proximal end of the tube to pass air and/or oxygen to the lungs. A stethoscope may then be used by medical personnel to listen for breathing sounds to ensure proper placement of the tube.
Often endotracheal intubation must be performed away from a clinic and in the field, particularly during a trauma and other emergency situations. Unfortunately, under such adverse conditions, it may not be possible to use a laryngoscope or a stethoscope to ensure proper placement of the endotracheal tube in the trachea, in which case the endotracheal tube may enter the esophagus.
In order to better ensure proper placement of the endotracheal tube in the trachea, a carbon dioxide sensor may be added to an adapter located at the proximal end of the endotracheal tube. However, because the carbon dioxide sensor is a separate component, use of the sensor may be overlooked. Furthermore, since the sensor is located at the proximal end of the endotracheal tube, the carbon dioxide measurements may not be particularly accurate. What is needed is an endotracheal tube to better ensure proper placement in the trachea during endotracheal intubation, as well as incorporate a carbon dioxide sensor which better ensures the sensor will be present, provides better placement for obtaining breathing samples from the lungs and addresses other needs in the art.